ORIGINAL STUDY GUIDE
Pharmacology
Nursing Pharmacology Made Manageable
Concept review + original practice questions with rationales
For nursing students — not affiliated with NCLEX®, ATI®, or HESI®
, About this guide. This is original educational material written to help you learn core nursing concepts. All practice
questions were written from scratch for this guide. It is a study aid, not real or recalled exam content, and is not affiliated
with or endorsed by any testing organization.
How to Use This Guide
Pharmacology feels overwhelming because students try to memorize individual drugs. The faster path is to
learn drug classes: once you understand what a class does, its mechanism, and its major nursing
considerations, you can reason your way through any individual drug in that class. This guide is organized
around that principle.
Core Principles
Pharmacokinetics vs. Pharmacodynamics
Pharmacokinetics — what the body does to the drug: Absorption, Distribution, Metabolism, Excretion
(ADME). Liver metabolizes; kidneys excrete. Impaired liver or kidney function raises the risk of toxicity.
Pharmacodynamics — what the drug does to the body: mechanism of action, therapeutic effect, and side
effects.
Key Terms Worth Knowing Cold
• Half-life: time for plasma concentration to fall by half. Longer half-life = less frequent dosing.
• Therapeutic index: narrow index (e.g., digoxin, lithium, warfarin) means small margin between effective
and toxic — monitor levels.
• Peak: highest concentration after a dose. Trough: lowest, drawn just before the next dose.
• First-pass effect: oral drugs metabolized by the liver before reaching circulation, reducing bioavailability.
High-Yield Drug Classes
Cardiovascular
Class Key nursing considerations
Beta blockers (-olol) Lower HR and BP. Hold if HR < 60. Do not stop abruptly (rebound
tachycardia). Mask hypoglycemia signs.
ACE inhibitors (-pril) Watch for dry cough, hyperkalemia, angioedema. First-dose hypotension.
ARBs (-sartan) Alternative to ACE if cough occurs. Still monitor potassium.
Calcium channel blockers Lower BP; watch for constipation, edema, bradycardia.
Diuretics (loop/thiazide) Monitor potassium. Loop diuretics waste K+; give K+-sparing or
supplement as ordered.
Digoxin Narrow therapeutic index. Check apical pulse 1 full minute; hold if < 60.
Watch for toxicity: nausea, visual halos.
Anticoagulants
Heparin — monitor aPTT. Antidote: protamine sulfate.
Warfarin — monitor INR (target usually 2–3). Antidote: vitamin K. Teach consistent vitamin K intake (leafy
greens).
Pharmacology
Nursing Pharmacology Made Manageable
Concept review + original practice questions with rationales
For nursing students — not affiliated with NCLEX®, ATI®, or HESI®
, About this guide. This is original educational material written to help you learn core nursing concepts. All practice
questions were written from scratch for this guide. It is a study aid, not real or recalled exam content, and is not affiliated
with or endorsed by any testing organization.
How to Use This Guide
Pharmacology feels overwhelming because students try to memorize individual drugs. The faster path is to
learn drug classes: once you understand what a class does, its mechanism, and its major nursing
considerations, you can reason your way through any individual drug in that class. This guide is organized
around that principle.
Core Principles
Pharmacokinetics vs. Pharmacodynamics
Pharmacokinetics — what the body does to the drug: Absorption, Distribution, Metabolism, Excretion
(ADME). Liver metabolizes; kidneys excrete. Impaired liver or kidney function raises the risk of toxicity.
Pharmacodynamics — what the drug does to the body: mechanism of action, therapeutic effect, and side
effects.
Key Terms Worth Knowing Cold
• Half-life: time for plasma concentration to fall by half. Longer half-life = less frequent dosing.
• Therapeutic index: narrow index (e.g., digoxin, lithium, warfarin) means small margin between effective
and toxic — monitor levels.
• Peak: highest concentration after a dose. Trough: lowest, drawn just before the next dose.
• First-pass effect: oral drugs metabolized by the liver before reaching circulation, reducing bioavailability.
High-Yield Drug Classes
Cardiovascular
Class Key nursing considerations
Beta blockers (-olol) Lower HR and BP. Hold if HR < 60. Do not stop abruptly (rebound
tachycardia). Mask hypoglycemia signs.
ACE inhibitors (-pril) Watch for dry cough, hyperkalemia, angioedema. First-dose hypotension.
ARBs (-sartan) Alternative to ACE if cough occurs. Still monitor potassium.
Calcium channel blockers Lower BP; watch for constipation, edema, bradycardia.
Diuretics (loop/thiazide) Monitor potassium. Loop diuretics waste K+; give K+-sparing or
supplement as ordered.
Digoxin Narrow therapeutic index. Check apical pulse 1 full minute; hold if < 60.
Watch for toxicity: nausea, visual halos.
Anticoagulants
Heparin — monitor aPTT. Antidote: protamine sulfate.
Warfarin — monitor INR (target usually 2–3). Antidote: vitamin K. Teach consistent vitamin K intake (leafy
greens).
